A great first week!

I am fortunate enough to have access to the internet today to update you on the rest of the week! I was in pediatrics yesterday, in the morning. The doctor was only there very briefly, but I was albe to follow him for about half an hour, and then I had the chance to talk to 2 medical students in Durban schools! It was interesting following the doctor because my observations (which were later confirmed by the knowledge of others) led me to believe that the nurses working there were not as educated as they should have been. The first case was a baby who looked unwell and was on oxygen. The nurse said that he was admitted for asthma, but when we looked at the x-ray, there was an opaque lobe on a chest x-ray! The first though from all of us was lobar pneumonia, and sure enough the child was being treated with a type of penicillin. Unfortunately the treatment had been started a few days ago and the child hadn't improved much. The doctor decided to prescribe another antibiotic (I think he is supposed to prescribe it in addition ie keep the child on the first one as well, but I'm not sure that he did... althuogh he was very good at what he was doing, so I'm sure he followed protocol!). Anyhow, he was suspicious that this infection was either not clearing because the child was immunocompromised, or that the infection might even be TB, which would again mean that the child was immunocompromised. The mother had claimed to be HIV-negative, saying she was just tested, but the doctor ordered a PCR anyhow (this is a unique test for children because the usual tests looking for antibodies against HIV are not made in a child until they reach 18 months... it is an expensive test from what I have heard, and it takes some time to get the results, but the doctor was very confident about ordering it... and for good reason). I hope that the child simply has an unusual case of pneumonia, but HIV is so common on the pediatric ward!
I was also able to go to the burns unit in the pediatric ward. This was very interesting. Burns are very common in children here. The families that live in the rural areas often live in one room houses, where they have to boil their water for everything. Often these families have many children, so as you can imagine it would be easy to have an accident where boiling water falls on one of the children running around. The children mostly had second degree burns. The one girl had second degree burns covering abour 40% of her body. Since she is so young, it is essential that all protocols are followed, the most important being fluid intake!!! This child was on an IV, but the nurses had not fed her more than 40mL in the last 13 hours, and she was supposed to be getting 40mL EVERY HOUR!!! Protein is also very important for these children because without skin on the wounds, protein is also lost. The therapist doing the assessment did not think the child would live until Monday.
It is so sad to think that there are such gifted doctors, but their orders are not being followed!! Someone shed some light on the situation, saying that the nurses are very unhappy with their wages and do not work as hard as they would, under different working conditions... this seems pretty typical of service providers that are unhappy with their working conditions, but these children are dying!!!
I was happy to get a chance to talk to the medical students about their experience with HIV. I asked them what their opinion of HIV is... like everyone else that we talked to, they said "you are lucky"... or, "lucky are you" when they discovered that HIV was not a big problem in Canada. They said that a big part of the problem was educations (which most of teh doctors also indicated). I asked them if they knew people living with HIV and they said yes, one had family members living with HIV. She said that yes, she has seen them decline and that it is very sad. However, she is just so frustrated to see people practice unsafe habbits despite knowing the risks!!! She doesn't understand why people take chances when they are surrounded by people suffering from the consequences. Obviously she was referring only to people who contracted hIV from risky behavious, and obviously she acknowledges that it is a complex problem, but it was interesting to hear her voice that simple and passionate frustration. I asked her if she thought that people here react to a positive HIV status as a death sentence. I feel as though many people in Canada would, despite knowing that the treatment prolongs life for decades potentially. She confidently said NO... people do NOT consider it a death sentence... they see people living with years of heath and a positive status. She indicated that yes, it is terrible and frightening news, but that people accept their status relatively quickly. I wonder if that causes people to be less frightened, increasing risky behaviour? I don't know... it's still a horrific disease and although there are years of health, there is also a time limit... eventually HIV will lead to AIDS, almost certainly before they would die of another cause.
This is a big prayer... but please pray that there will be enough education and fear about contracting HIV in those individuals that are engaging in risky behaviours, so that they will take precautions.... they can save their life if they just take precautions!!!! Please pray that God will help those can use precautions to use them.
Yesterday the group went to the market and we shopped at some locals' stands. Then a few of us went to the horse races, where everyone dressed up in their very best (except us of course haha) and bet on the races. It was so fun to watch everyone there!!! We went out for dinner after that, which was great. This afternoon we will be going to the beach to watch a surfing competition. I am very excited about that.... apparently there is an air show on too!
This will be the last email that I write before I come back from my rural rotation next Monday. I will not be in clinic again until Tuesday, which will be my first day in the rural hospital. I'm excited to go to this family; I have heard that they dance in the evenings! We will be getting picked up Saturday morning to go to a game reserve and then we will be coming home on Sunday. I hope that I can update you on the week next monday.
Please pray for this next week, that I will stay safe and learn a lot!